Begaye promotes Navajo owned and operated Managed Care Organization

Navajo Nation President Russell Begaye told a group of HHS officials that implementing a Navajo MCO will help to reinvest revenues into developing health care programs to address existing health disparities. (Office of the President and Vice President)

TWIN ARROWS, Ariz. — Navajo Nation President Russell Begaye told the U.S. Department of Health and Human Services (HHS) that a Navajo owned and operated Managed Care Organization (MCO) is needed to expand the nation’s current health system.

Begaye met with HHS directors during a Navajo Regional tribal consultation that was held at the Twin Arrows Conference Center June 26. The purpose of the consultation was for HHS to hear the tribe’s priority health concerns.

Begaye prefaced his address by reiterating the federal government’s responsibility in upholding the contractual agreements of the treaties they’ve entered into with Native American nations.

“When we talk about improving the health of the nation, it’s based on the treaty agreement we’ve made with the federal government,” Begaye said. “When we speak about improving programs, budgets, facilities and personnel, we are speaking based on the agreement that we’ve made with the government. We come to the table as one of the 300 treaty tribes.”

In working toward the goal of establishing a valued and effective Navajo health system, Begaye said the Nation is developing a medical school in collaboration with the Burrell School of Osteopathic Medicine. Studies show that medical students are more inclined to work where they’ve completed their residency program.

“The goal of this school is for medical students to fulfill their clinical work requirements at an Indian Health Services (IHS) hospital,” Begaye said. “We are asking IHS to develop a residency program at all IHS hospitals. We need your support in this to optimize long term health care employment in our hospitals.”

The level of health care services that the Navajo Nation needs to deliver is equivalent to the level provided by outside healthcare facilities. However, adequate specialty care isn’t available across the Nation. In addition to developing a workforce of medical physicians, the Navajo Nation is moving to expand specialty care services to include oncology, cardiology, 24/7 clinics and pediatrics.

To build these specialty facilities, the nation is implementing its own Managed Care Organization (MCO), initially addressing its membership in New Mexico. By managing Medicaid coverage for Navajo tribal members in New Mexico, the Navajo Nation stands to capture millions in Medicaid reimbursements that currently go to outside healthcare facilities in New Mexico.

“In our conversations with Congress on the New Mexico side, we’ve established that they will drop legislation on our behalf to help implement this Navajo owned and operated MCO,” Begaye said. “The amount of revenue that this venture can produce for the Nation will be reinvested in developing the programs we need to address the existing health disparities.”

Begaye clarified that the Navajo MCO is specifically for Navajo tribal members and is not an attempt to assume health benefits of non-Navajo tribal members. Although there will be provisions for non-tribal members to opt into the Navajo MCO, those provisions are to accommodate non-tribal members who live on the Nation or in counties where Navajo health facilities exist.

“We are taking a huge step in assuming Medicaid and we appreciate the ongoing support of HHS. We ask that HHS continue to support CMS in developing guidelines and regulations in the implementation of the Indian Managed Care (ARRA) legislation,” Begaye said. “We look forward to continuing working with the state to address concerns regarding the scope of the Navajo MCO. However, we are aggressively pursuing this vision and the MCO will be the first step to building our healthcare system.”

Begaye also advocated to HHS to ensure that current Navajo health care developments are on track like the hospitals in Dilkon, Bodaway-Gap and Pueblo Pintado.

“Navajo health care issues are vast and extensive. We want to make sure that our issues are addressed and we appreciate the opportunity to sit at the table today,” Begaye said.

Information provided by the Office of the President and Vice President

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